Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

Amanor-Boadu, Sasraku; Hipolito, MariaMananita S; Rai, Narayan; McLean, Charlee; Flanagan, Kyla; Hamilton, Flora; Oji, Valerie; Lambert, Sharon F.; Le, Huynh Nhu; Kapetanovic, Suad; Nwulia, Evaristus

doi:10.5498/wjp.v6.i1.128

Cited by 20 publications

(16 citation statements)

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“…In our study, higher levels of depression symptoms were associated with higher viral loads, a finding consistent with other studies (Amanor-Boadu et al, 2016;Herkenham & Kigar, 2016). However, this association was only found in women, the group with a smaller sample size.…”

Section: Discussionsupporting

confidence: 92%

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Comparison of levels of anxiety and depression between women and men living with HIV of a Mexico City clinic

Caballero-Suárez

Rodríguez-Estrada

Candela-Iglesias

et al. 2017

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Introduction. Studies show that women with HIV have higher depression, anxiety symptoms and worse quality of life than men with HIV, but limited data on mental health status of people living with HIV (PLWH) is available in Mexico, hindering the development of specific mental health interventions. Objective. To compare the frequency and severity of depression and anxiety symptoms between men and women of a HIV specialized clinic of Mexico City. Method. Data were derived from a cross-sectional survey on condom use and serostatus disclosure carried out between 2012-2013. Data from Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic characteristics were included in this study. Non-parametric tests were used to compare sociodemographic, clinical and psychological variables and odds ratio were calculated. Results. 291 PLWH were included, 13.1% (n = 38) were women. Significant differences between genders were found in sociodemographic variables (age, marital status, occupation, education, sexual orientation), but not in clinical variables. Depression symptoms were present in 45% of women versus 18.6% of men (x 2 = 13.17, p < .001) and anxiety symptoms were present in 47.4% of women and 30% of men (x 2 = 4.53, p = .033). In unadjusted analysis, women had 3.5 times higher risk than men of presenting depression symptoms (OR = 3.54, 95% CI = 1.61-7.65, p < .001) and 2 times higher risk of having anxiety symptoms than men (OR = 2.01, 95% CI = 0.98-4.42, p < .033). Discussion and conclusion. An important percentage of participants had depression and anxiety symptoms; women showed greater frequency and severity of symptoms as well as greater socioeconomic vulnerability. Mental health interventions are needed and should take into consideration the gender specific differences.

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Section: Discussionsupporting

confidence: 92%

“…Anxiety and especially depression have consistently been associated with poor antiretroviral treatment (ART) adherence (Safren et al, 2016;Smith Fawzi et al, 2016;Tao et al, 2016;Tatum & Houston, 2016), and are linked to poor virological control and lower CD4 T cell counts (Amanor-Boadu et al, 2016;Herkenham & Kigar, 2016).…”

Section: Introductionmentioning

confidence: 99%

Comparison of levels of anxiety and depression between women and men living with HIV of a Mexico City clinic

Caballero-Suárez

Rodríguez-Estrada

Candela-Iglesias

et al. 2017

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“…This is contrary with result by Bitew et al, who reported CD4 count < 500 cells/μL as a predictive factor of suicidal thoughts with AOR of 2.5 [41]. Amanor-Boadu et al went further and defined CD4 count as a clinical marker of untreated depression in African-American PLHIV [67]. In progressive HIV disease, low CD4 count was associated with AIDS defining illness and increasing mortality, while untreated depression and poor ART adherence were independently associated with poorer CD4 outcomes [63].…”

Section: Discussionmentioning

confidence: 76%

Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

et al. 2020

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Background Suicidal behavior is a prevalent psychiatric emergency in HIV-infected adults. Detection of suicidal ideation is important in planning early psychiatric intervention and optimizing HIV/AIDS management. Characterization of suicidal ideation among HIV-infected adults is crucial; however, practically there is no data in Indonesia, the country with the second largest burden of HIV/AIDS epidemic in Asia. This study aims to identify suicidal ideation and analyze the associated psychopathology and determining factors among HIV-infected adults in Indonesia. Methods An observational cross-sectional study was conducted among HIV-infected adults aged 18–65 years old receiving antiretroviral therapy (ART). Measurement using Symptom Checklist-90 (SCL-90) was performed to assess the existing psychopathology. Firth’s penalized logistic regression analysis was performed to identify factors associated with suicidal ideation. Results A total of 86 subjects were recruited. Most subjects were male (65.1%), median age was 35 years, and median latest CD4 count was 463 cells/μl. Lifetime suicidal ideation was identified in 20 subjects (23.3%). Mean SCL-90 T-score for depressive and anxiety symptoms were both significantly higher among subjects with suicidal ideation (M = 60.75, SD = 12.0, p = 0.000 and M = 57.9, SD = 2.8, p = 0.001, respectively) compared to those without. Bivariate analyses showed that lifetime suicidal ideation was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. Multivariate analysis identified that a single-point increase in SCL-90 depression symptoms score (AOR 1.16, 95% CI 4.5–123.6, p = 0.000) and efavirenz use (AOR 5.00, 95% CI 1.02–24.6, p = 0.048) were significant independent factors related to suicidal ideation. Conclusion Suicidal ideation is commonly found among Indonesian HIV-infected adults on ART. Depressive symptoms and efavirenz use are independent factors related to the presence of suicidal ideation. Thus, early screening of psychopathology as well as substitution of efavirenz with other ART regiment are recommended to prevent suicide and improve HIV/AIDS management outcome.

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“…Health behaviors, treatment adherence, and use of support and health services could impact aspects of physical and mental health such as immune function and psychiatric symptoms. Prior work published by the investigators reported poor CD-4 count association with poor ART adherence and MDD, which persists where MDD is untreated 5. Faith beliefs could be assessed to help improve adherence and psychiatric symptom treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Comorbidity of HIV+ and depression reportedly could impact health outcomes with clinical, economic, and/or humanistic consequences. Depression rates are higher among HIV+ individuals than the wider US population; higher among HIV+ women, minorities, and individuals with co-existing substance use 5–11. Depression has been associated with poorer CD-4 T-cell counts, higher HIV+ viral loads, lower antiretroviral therapy (ART) adherence, poorer prognosis, and higher mortality 12–15.…”

Section: Introductionmentioning

confidence: 99%

Spiritual care may impact mental health and medication adherence in HIV+ populations

Oji¹,

Hung²,

Abbasgholizadeh³

et al. 2017

HIV

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ObjectiveTo explore a potential role for spirituality in medication-related needs assessment for integrated care in chronically ill populations.MethodA systematic literature review was conducted to explore the impact of faith beliefs on health and/or medication adherence in individuals with depression and/or HIV+/AIDS. Retrospective electronic medical record review of adult HIV+ patients of an urban primary care clinic with integrated mental health services was conducted, with Substance Abuse and Mental Illness Symptoms Screener (SAMISS), major depressive disorder (MDD) incidence over the preceding year, and history of contact with a spiritual advisor. A convenience sample was interviewed to qualitatively assess potential medication therapy management needs and medication-related problems. Another sample was examined utilizing the Daily Spiritual Experience Scale.ResultsThe literature reports positive influence on health behaviors, coping and outcomes; and poor medication adherence and treatment decisions due to patient passivity or resistance. Spiritual advisor contact (not limited to a specific religion) was significantly associated with MDD absence (1.7% vs. 15.3%, P<0.005) and inversely related to SAMISS, depression, and poor health behaviors. Patient interviews reflected significance of faith in terms of insight and acceptance of illness, the role or need for medications, coping, and medication adherence. An illustrative model was designed based on the literature and data collection.ConclusionSpiritual assessment may help identify positive or negative influence on health. Spiritual interventions could be beneficial in promoting adherence and positive health outcomes. Further research is recommended.

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Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

Abstract: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

Cited by 20 publications

References 47 publications

Comparison of levels of anxiety and depression between women and men living with HIV of a Mexico City clinic

Comparison of levels of anxiety and depression between women and men living with HIV of a Mexico City clinic

Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

Spiritual care may impact mental health and medication adherence in HIV+ populations

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